- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $478.63 / $776.25 / $14,454.40
| Facility | | $478.63 | $776.25 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $346.74 / $478.63 / $977.24
| Professional | | $346.74 | $478.63 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $5,011.87 / $7,943.28 / $13,182.57
| Facility | | $5,011.87 | $7,943.28 | $13,182.57 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $380.19 / $724.44 / $2,137.96
| Professional | | $380.19 | $724.44 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $977.24 / $1,148.15 / $1,819.70
| Facility | | $977.24 | $1,148.15 | $1,819.70 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $616.60 / $1,202.26 / $1,380.38
| Professional | | $616.60 | $1,202.26 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $7,413.10 / $14,454.40
| Facility | | $446.68 | $7,413.10 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $812.83 / $1,000.00 / $1,174.90
| Professional | | $812.83 | $1,000.00 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $7,585.78 / $12,589.25
| Facility | | $446.68 | $7,585.78 | $12,589.25 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $467.74 / $776.25 / $1,905.46
| Professional | | $467.74 | $776.25 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $32.36 / $33.11 / $85.11
| Professional | | $32.36 | $33.11 | $85.11 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,762.47 / $8,709.64 / $9,120.11
| Facility | | $7,762.47 | $8,709.64 | $9,120.11 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $562.34 / $1,148.15 / $1,698.24
| Professional | | $562.34 | $1,148.15 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $575.44 / $912.01 / $1,621.81
| Professional | | $575.44 | $912.01 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $7,585.78 / $7,585.78 / $10,964.78
| Facility | | $7,585.78 | $7,585.78 | $10,964.78 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $660.69 / $1,862.09 / $2,818.38
| Professional | | $660.69 | $1,862.09 | $2,818.38 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $1,995.26 / $1,995.26 / $1,995.26
| Professional | | $1,995.26 | $1,995.26 | $1,995.26 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $2,187.76 / $2,630.27 / $3,019.95
| Professional | | $2,187.76 | $2,630.27 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Typical Low / Median / Typical High
- $6,606.93 / $10,232.93 / $12,022.64
| Facility | | $6,606.93 | $10,232.93 | $12,022.64 |
- Facility/Professional
- Professional
- Modifier
- Typical Low / Median / Typical High
- $446.68 / $758.58 / $1,698.24
| Professional | | $446.68 | $758.58 | $1,698.24 |